Category: Immune System

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How Your Gut Affects Your Immune System

Did you know that your biggest exposure to the outside world every day is through your mouth?  That’s why 70% of your immune system lives in your gut, lying in wait to protect you from anything that seems foreign to the body (called antigens because they stimulate the immune system), which believe it or not includes food and the toxins and microbes that ride along with the food that you ingest while eating.

Your gut, which starts in your mouth, travels through your stomach, small intestine, colon or large intestine, and ends in your rectum, is supposed to be a closed tube – with the intestinal lining creating a barrier that separates the inside of your body and immune system from these outside exposures.  When you digest your food, the intestinal lining can then selectively choose what can enter your body by opening and closing special gates called tight junctions.

In functional medicine, an intestinal barrier with damaged tight junctions that isn’t keeping antigens out of the body is known as a leaky gut.  Studies have increasingly found that a leaky gut can damage the functioning of your immune system and is also associated with arthritis, autoimmune disease, allergies, and food sensitivities.

Causes of leaky gut vary, but the most important is dysbiosis, which is an imbalance in the bacteria in the gut, also called the gut microbiome.  Dysbiosis can be an overgrowth of harmful bacteria, yeast or parasites, or not enough good bacteria, and is commonly caused by a poor diet, a course of antibiotics, frequent use of antacids, stress, and many other things like medication and toxins. These gut bacteria are important because they interact with your immune system to keep it healthy, and they turn the food we eat into healthy compounds called short chain fatty acids which heal the tight junctions between your cells and also support immune health. 

The good news is that you can rebuild your microbiome and repair your gut, and this is the best thing you can do to maintain and improve the health of your immune system. Here is how to do this:

  1. CHANGE YOUR FOOD:  has the most influence on the diversity of the microbiome, and that’s why you should always start with changing your diet by increasing fruits and veggies, especially those rich in polyphenols, bioflavonoids, and fiber because these tend to increase the good bacteria that make short-chain fatty acids and heal the gut. Also, you need to remove foods from your diet that feed the bad bacteria like sugar, processed flour products, alcohol, and too many animal products (more than 30% of your daily diet).  You also need to test yourself for food sensitivities and remove sensitive foods such as gluten, dairy, soy, corn, eggs and the nightshade vegetables. Our elimination diet explainer shows how to do this. 
  2. TREAT YOUR DYSBIOSIS:  At Blum Center for Health we start with cleansing herbs like berberine, grape seed extract, black walnut, and oregano that can clear out bad bacteria and yeast from the gut ecosystem. In fact, we created our own custom herbal antibiotic mix called Gut Cleanse, and we use this in our do-it-yourself 10 or 30-Day Gut Cleanse Program.  Once you have eliminated the bad bacteria and yeast, probiotics and the right food can help you rebuild the good stuff, repair the gut lining, reduce inflammation, and eliminate food sensitivities. 
  3. TAKE A PROBIOTIC:  These are supplements filled with different strains of beneficial bacteria that help positively influence your gut ecosystem and improve the functioning of your immune system.  We recommend probiotics as a foundation for supporting immune health.  

These simple steps will not only improve your gut function, but will also lay down a foundation for immune health that will continue to improve in the future.

 

 

Check out my FREE 3-part video series! Last month I led live classes on the immune system and I’m happy to share with you the three videos:  How To Boost Your Immunity and Resiliency to Viruses: DOWNLOAD FREE NOW

Susan Blum, MD, MPH an Assistant Clinical Professor in the Department of Preventive Medicine at the Icahn School of Medicine at Mount Sinai, has been treating, healing and preventing chronic diseases for nearly two decades. A Preventive Medicine and Chronic Disease Specialist, Dr. Blum is the Founder and Director of Blum Center for Health in Rye Brook, New York, where she leads a multi-specialty team of physicians, nurse practitioners, nutritionists and health coaches, all providing cutting edge Functional and Integrative Medicine services.

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HOW TO HANDLE CANCER DURING THE PANDEMIC

Do you have a health condition, like cancer, that you’d normally seek medical care for but you haven’t during the coronavirus pandemic?  Is this because you think you’re safer at home and going out would risk infection, or your usual physician is not available to see patients?  You aren’t alone.  

One of the most disconcerting things to me as a physician during this pandemic is that the other medical conditions people have been suffering with have mysteriously disappeared.  It makes sense that emergency rooms have noted a dip in occurrences like car fatalities and injuries since many of us are not out and about driving. However, what about heart attacks and strokes?  These are time-sensitive events that if treated early, make a significant difference in someone’s survival.  Many people are afraid to call an ambulance or go to the ER with concerning symptoms like chest pain or sudden weakness in parts of the body because they fear they will get infected with Sars-CoV2.  And unfortunately this is leaving many people to die at home or they are left with permanent disabilities because they received medical attention too late.  These are not conditions where the wait-and-see approach works.

SCREENINGS FOR CANCER DURING THE PANDEMIC

Have you been due for your regular screening colonoscopy or mammogram and have delayed calling to make that appointment because it isn’t an emergency or you decided it can wait until we have some clarity about returning to normal life? Again, you are not alone.

In a typical year, roughly 150,000 cases of cancer are detected monthly in the US population.  As a physician specializing in Integrative Oncology, I am very concerned that people with signs of cancer – a new mass or lump – are not being assessed quickly enough and that these new cases are being missed in the earliest stages when treatment is most effective.  Many people have been choosing to wait until it is “safe” to make the phone call for an appointment.  Every doctor and health system is doing their best to create a safe environment for patients, and while we don’t have all the answers, it is now time to reach out to your provider through telemedicine and share your concerns so that you can create a plan of action together.

CANCER AND COVID

As someone with cancer during the coronavirus pandemic,  are you concerned about what you can do beyond secluding yourself at home? 

During the past 3 months, I have been hearing from many of my cancer patients with concerns about what else they can do. Whether they have a past history of cancer, or are actively in treatment, these patients are looking to have an action plan in place that will help when they are going to reintegrate into the world.  

During this exceptional time, it has also been more difficult for my cancer patients to find some semblance of security in their treatment or monitoring.  Many have felt that their diagnosis has taken a backseat to the pandemic at large.  One of my patients called for a telemedicine followup with her oncologist to find that he was recruited by his hospital to work in the ER managing COVID-19 patients.  Another patient was told to forgo treatment for one month due to a high risk of exposure; her tumor markers became elevated the following month.  Others have found that when they questioned their current regimen, they were told to stay the course until things resumed to a more normal format.  And just like everyone else, those with cancer are very reluctant to go to an ER (whether for a cancer related issue or anything else like heart attack or stroke symptoms), because they are known to be a high-risk category because of a weakened immune system. 

INTEGRATIVE ONCOLOGY

I have been practicing integrative oncology for well over 15 years, helping people to navigate through conventional treatments by offering ways to naturally mitigate symptoms from chemotherapy, radiation and surgery as well as exploring other areas of evidence based treatments that lie outside of the box of their oncologist.  Often, people seek me out to support their treatment nutritionally or to “boost immunity” during treatment, and this is a good place to start.  But then most people discover there is a plethora of other adjunctive possibilities outside of what their oncology team has offered.  Cancer is a diagnosis that I hope that one would consider all angles and possibilities and various opinions to help construct the most solid plan to move forward and try to conquer the disease.

One of the areas that I focus on is supporting immunity and treating immune issues with these patients.  It is interesting to me that many of the natural herbal and nutraceutical treatments that I have used in cancer for various reasons, have activity in some format against Sars-CoV2. For example, I’ve  utilized Chinese Skullcap (also known as scutellaria baicalensis) in both breast and ovarian cancers (as well as other cancers such as colorectal and prostate cancer) because of its anti-proliferative activity against tumor cells but interestingly it has a place in combating Sars-CoV2 by enhancing not only immune function but also possessing anti-inflammatory activity for a variety of cytokines and can potentially block the virus from attaching to ACE-2 receptors that are unique to this virus.  A good review can be found HERE.

The field of integrative oncology is immense and I have always gravitated to working with cancer patients for a number of reasons.  It presents an incredibly difficult time that often necessitates a change in mindset, which allows me to show people that this challenge is an opportunity not only to make positive and sometimes radical change in one’s life. It’s also a time to take control and not always assume that there is nothing out there beyond what the oncologist or surgeon is offering.  And with over 100 peer reviewed publications that come out daily, the field is constantly evolving and my work is never “protocol.”  These are just a few reasons why I find working with cancer patients extremely rewarding. The current pandemic adds yet another layer to work through with patients and I accept the challenges ahead.

 

Pamela Yee, MD is an Integrative Physician at Blum Center for Health in Rye Brook, NY where she creates highly personalized treatment plans for each of her patients. Dr. Yee has a special interest in integrative cancer care, immune disorders, and lyme disease. She lives in Nyack NY where she and her husband manage their own organic micro-farm.

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An Update on Supplement Usage During the Coronavirus Pandemic

An Update on Supplement Usage During the Coronavirus Pandemic

As of 5.8.20

By the team at Blum Center for Health:  Susan S. Blum, MD, MPH; Pamela Yee, MD; Elizabeth Greig MSN, FNP 

As the days turn into weeks, we are learning more and more about how this virus behaves, and what we might do to support our immune system to better protect ourselves.  From a Functional/Integrative medicine perspective, thus far we have been focusing on nutrients and herbs that have been well studied, in general, for their ability to support, modify or boost the immune system.  I have been talking and writing extensively on helping people to choose the right supplements.

Today, I have updated this blog to reflect new information that I want to share with you.  

Summary of what we’ve already discussed so far:

ACE receptors:  We have learned that this virus uses the ACE receptor on cells to gain entry.  This led to alarm bells in the Integrative Medicine community because we have read that one of the many actions of Vitamins D could be to increase the number of ACE receptors on the cells.  HOWEVER, now, after reading the most recent studies on this topic, it appears that what’s more important is the level of Angiotensin Converting Enzyme 2 (ACE 2) in the blood, and NOT the amount of receptors.  And since Vitamin D might help reduce the levels of ACE 2 (a good thing), it appears that the concern about ACE receptors is a thing of the past and we can safely take Vitamin D.

Cytokine storm:  When the virus gets going in your body, it can sometimes create something called a cytokine storm, which is when your immune system reacts vigorously and releases an enormous amount of chemicals (cytokines) and free radicals to destroy the virus. Specifically, it is caused by activation of NFKB and an overacting NLRP3 Inflammasone, the system that makes these cytokines.  

There is concern that in some people, among other things, the cytokine storm contributes to the lung damage that we hear about.  We have been reading about the possibility that some immune boosting vitamins might make the cytokine storm worse by increasing the NLRP3 inflammasone system.  Many of you have been contacting us, asking for guidance on this.

Here is new information, as of May 8, 2020.  

We are changing our recommendations based on the release of a comprehensive review by the Institute for Functional Medicine, of the following supplements.

We must state that there are no studies that prove that any of the below supplements contribute to a cytokine storm, and there is now a widespread understanding that these supplements are all safe to take, and will not have a negative effect on cytokine storm, if it happens.  

**Please note that these recommendations are NOT medical advice.  Most are not safe for pregnant women, and if you are taking medication or have any serious health condition, please check with your doctor.

IMMUNE BOOSTING SUPPLEMENTS

Vitamin D:  5000 IU daily in absence of serum levels from a blood test.  

Vitamin A:  up to 10,000 – 25,000 IU/day  

Vitamin C:  1-3 grams daily

Elderberry:  500 mg daily (of USP standard of 17% anthocyanosides)

Beta Glucans:  250 – 500 mg daily

Mushrooms:  Shiitake, Lion’s mane, Maitake, Reishi.  Dose depends on preparation

N-Acetylcysteine (NAC):  600 – 900 mg twice/day

ANTIVIRAL SUPPLEMENTS

Zinc:  30 – 60 mg daily in divided doses

Licorice root:  200-400 mg/day in divided doses, standardized to glycyrrhizin.  Short term use <4 weeks.

Also Vitamin C

REDUCE CYTOKINE STORM (NLRP3 Inflammasone)

Resveratrol:  100 – 150 mg daily

Melatonin:  5-20 mg daily

PEA:  Palmitoylethanolamide:  300 mg twice/day for prevention.  600 mg 3 x daily for 2 weeks to treat infection.

ANTIVIRAL PLUS REDUCE CYTOKINE STORM

Curcumin:  500 – 100 mg twice/day.  Choose absorption enhanced.  

EGCG:  4 cups daily or 225 mg daily

Chinese Skullcap:  750-1500 mg/day.   Standardized to flavonoids baicalin or baicalein.

Quercitin:  1 gram twice/day.  Phytosome:  500 mg twice/day

PUTTING THIS TOGETHER

  • Supplements: 
    • We suggest choosing supplements from each category so that you have the broadest support possible.  
    • You don’t need to take ALL of the recommended vitamins and herbs.  
    • As a core program, make sure to take Vitamin D, C, and Zinc.
    • Next, the most common that we recommend are Vitamin A, Curcumin and Mushrooms (or Beta Glucan).
    • After that you can choose additional supplements from the list above as desired or needed.
    • You can find our COVID Immune recommendations for purchase on Fullscript.  Click here to sign up and order from that dispensary.
  • Remember, if you develop a fever, consider not taking any fever suppressing medication because fever helps kill the virus.  However, it is dangerous to let your fever go over 103, and so if you need it, consider taking Tylenol (Acetominophen) instead of ibuprofen (Advil).  It appears that ibuprofen may make things worse.  This is another area that is rapidly evolving, and if you can’t find Tylenol in the stores, you should speak to your doctor about other options.
  • Here are the things you should STILL DO for risk reduction: 
    • Good gut health: which means lots of beneficial bacteria. Take a probiotic every day with at least 20 billion cfu of mixed strains lactobacillus and bifidus species. 
    • Balanced stress hormones: Get a good night’s sleep and don’t overwork yourself during flu season. Stress harms your ability to fight viruses.  Practice some form of mediation daily.  Melissa, Blum Center’s Health Coach,  wrote a great blog with tips for managing stress during this time. 
    • Eat foods that are good for your immune system: Avoid processed foods and focus on fruits and veggies that are rich in antioxidants and vitamins. Support the removal of toxins by eating lots of cruciferous veggies, which boost the detox system in your liver.

Sending prayers and good wishes for you and all of us to stay safe and well during this challenging time. 

 

Check out my FREE 3-part video series! Last month I led live classes on the immune system and I’m happy to share with you the three videos:  How To Boost Your Immunity and Resiliency to Viruses: DOWNLOAD FREE NOW

 

 

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Tips for Boosting Your Immunity

My anti-viral approach is to help you build a strong immune foundation so that you boost your immunity and don’t get sick from any virus. A strong immune system is the basis for staying healthy in general and should be a year-round strategy…not just during flu season or when there is a threat of a novel previously unknown virus. This is, by far, the best prevention and protection!

Good gut health: which means lots of beneficial bacteria. Take a probiotic every day with at least 20 billion cfu of mixed strains lactobacillus and bifidus species. If you are taking antacids or proton pump inhibitors -stop- because this alters your gut flora in a negative way.

Balanced stress hormones: Get a good night’s sleep to boost your immunity and don’t overwork yourself during flu season. Stress harms your ability to fight viruses.

Eat foods that are good for your immune system: Avoid processed foods and focus on fruits and veggies that are rich in antioxidants and vitamins. Support the removal of toxins by eating lots of cruciferous veggies, which boost the detox system in your liver.

Take your vitamins! Here are some important ones you will need:

a. Vitamin D 2000 iu/day minimum. The dose is based on your blood levels, so if you havelow vitamin D you will need more.

b. Vitamin A retinyl palmitate 5000 iu/day. If you are pregnant or nursing, do not take morethan 5000 iu/day of this kind of Vitamin A (retinyl palmitate).

c. Zinc 30 mg/day.

d. Vitamin C 3-4000 mg/day as an immune booster. 1-2000 mg/day is good for general prevention.

Additional supplements to consider to boost your immunity:

a. N-Acetylcysteine (NAC):  One of my favorites for preventing cold and flu. NAC is widely used in the medical community for a number of conditions , and has terrific clinical data that shows it to be helpful for patients with chronic respiratory illnesses ( and so it is very useful for support treating respiratory viral illnesses). It also converts to Glutathione, the body’s most powerful antioxidant.  I usually recommend 900 milligram capsules or tablets – start with one twice daily and increase to two twice daily if needed. Pharmanac, a Canadian brand that comes in an effervescent form is easy to take as a fizzy drink – even for children!

b. Whey Protein Powder is high in immunoglobulins that boost your immune system. For a non-dairy alternative, try SBI Protect powder from Orthomolecular, packed with immunoglobulins

c. Herbs like Elderberry, Echinacea, Astragalus, and Beta Glucan (mushroom extracts). We love Immunoberry Liquid from Designs for Health, which is a potent and convenient blend of these. 1 dropper each day in your shake, or in a little water, is all you need for ongoing protection. We also love Immune Builder from Mushroom Science: 2 daily for prevention. Both of these supplement doses can be doubled or tripled if you are concerned that you had exposure or feel you have early symptoms of a viral illness.

Lastly, make sure to wash your hands multiple times a day — especially before you eat, and after exposure to public transportation like riding the subway.

 

Check out my FREE 3-part video series! Last month I led live classes on the immune system and I’m happy to share with you the three videos:  How To Boost Your Immunity and Resiliency to Viruses: DOWNLOAD FREE NOW

The items listed are available for purchase from our office, or from our online store:

https://us.fullscript.com/welcome/blumcenter

 

Susan Blum, MD, MPH an Assistant Clinical Professor in the Department of Preventive Medicine at the Icahn School of Medicine at Mount Sinai, has been treating, healing and preventing chronic diseases for nearly two decades. A Preventive Medicine and Chronic Disease Specialist, Dr. Blum is the Founder and Director of Blum Center for Health in Rye Brook, New York, where she leads a multi-specialty team of physicians, nurse practitioners, nutritionists and health coaches, all providing cutting edge Functional and Integrative Medicine services.

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10 Ways to Influence Your Immune System and Autoimmune Recovery

Truth #1: Autoimmune recovery is possible.

Truth #2: There is no one way to get there — everyone is unique. What works for me may not work for you. And, what works for you may not work for me. Don’t let anyone tell you otherwise.

Truth #3: There a multitude of core principles at play and finding your right mix is critical to reversing your condition. 

Truth #4: There is one key to this entire process that no one mentions. Stick with me and I will share it with you.

For the past 3 years I’ve had the privilege of working side-by-side with Dr. Susan Blum, one of the foremost authorities on autoimmunity. I work with patients at Blum Center for Health and with individuals through our CoachMe online platform, to implement the four steps of Dr. Blum’s international bestselling book, The Immune System Recovery Plan.

From working with hundreds and hundreds of people, I can tell you this: The Four Steps Work!

You might be wondering, “What are the four steps?”  They are: 1) Food as Medicine 2) Learning to Relax 3) Healing the Gut and 4) Supporting the Liver

Within those steps there’s a lot to learn, and it’s within those steps that things get personal. Here’s where YOU come into the equation. If you’ve been struggling with an autoimmune condition and autoimmune recovery, look at little deeper — look within the steps.

Keep your eyes peeled for her new LIVE course: Immune System Strong!  Slated to start late September (it will be here before you know it!) Immune System Strong will feature 4 LIVE classes with me that feature tangible next steps that you will be able to implement immediately, as well as community, accountability, group coaching and access to the answers you need on a daily basis.  Details will be available soon! Get On The First-To-Know List (even if you’re only a little bit interested), because we’ll be rewarding with an offer that won’t be available to anyone else.) I want the special reward!

10 Ways to Influence Autoimmune Recovery

Eating the Right Foods — You’ve probably heard the phrase, “Food is Medicine.” Indeed it is! And, it can also be your poison. The first step to relieving symptoms, and getting a grip on which foods are right for you, is to do an autoimmune elimination diet. This is not only therapeutic, but it is also diagnostic. When done properly you walk away with a personalized nutrition plan.  How does this differ from person to person? Someone with an autoimmune arthritis, for example, may need to remove nightshades. Someone who is struggling with digestive distress may need to consider high lectin foods that might be exacerbating symptoms. The great news is, that once this short-term food plan is complete many people successfully reintroduce favorite foods back into their diet.

Healing your Gut — About 70% of your immune system lives in your digestive tract!  Nearly everyone who suffers with an autoimmune condition needs to heal their gut. Think of your gut as a garden with trillions of good bacteria, and includes hundreds of different species. Pretty cool, right? But when all those beautiful good bacteria get infiltrated with bad bacteria, yeast or parasites, the good bacteria get crowded out. And that, right there, can compromise the integrity of your digestive tract lining, creating minuscule breaks in the barrier where food leaks into the bloodstream. This is known as Leaky Gut Syndrome. Healing your gut is a CRITICAL component to healing your autoimmune condition.  And the amount of gut damage is different from one autoimmune person to another, and thus the treatment and focus will need to be different, too. 

Supporting your Liver — We live in a world filled with toxins that can trigger autoimmune disease and harm the immune system. These include pesticides/herbicides, hormones and plastics in food and water, solvents and mold in our homes and heavy metals in the fish we eat and water we drink. Others can come from cosmetics and products we use at home. At Blum Center for Health, we also believe that some relationships, home and work environments and thoughts can be toxic and have a negative impact on the body. We highly recommend detoxing at least once a year. This is another place where things get personal – your toxin exposure is going to be different than everyone else’s, and how much detox you need will be different, too. 

Taking the Right Supplements — Targeted supplements facilitate healing, reduce inflammation, heal the gut, and remove toxins. It’s important to use medical grade supplements that do not contain fillers, preservatives, additives, gluten, dairy, soy or corn. You’ve got to check labels carefully. You could very well be putting something in your body that’s contributing to your autoimmune condition!  

Learning to Relax — Stress, even low grade stress (you know, they kind we wave away, like having to make lunch everyday for your kids to take to school) fuel the fire of autoimmunity. Even good stress, like getting ready to go on vacation, can cause a flare. Many people will get on board with the food plan, and start taking the appropriate supplements, but have a hard time implementing a stress reduction process. This may very well be the most difficult part of an autoimmune program. And this is where coaching can make all the difference in the world. In a world that’s built on distraction and endless motion it can be difficult and uncomfortable to be quiet with oneself. 

Implementing Exercise When You Don’t Feel Well — Exercise is one of those “loops”— you don’t feel well so you don’t exercise (don’t worry, I feel the same) and when you don’t exercise you don’t get its anti-inflammatory benefits. Drop all the ideals you have about exercise: the person running on a treadmill, the women pushing weights at the gym, the man doing headstands in a yoga class, the people doing hardcore spin. You don’t have to go to the gym! You don’t have to run on a treadmill! You don’t have to do weights! You just have to start with moving. Start slow. Start low. Start with something you enjoy. Just start.

Getting enough Sleep — The research is clear: Lack of sleep or poor sleep impacts just about every system in your body, and increases inflammation. It increases your risk of autoimmunity and if you already have an autoimmune condition it impedes your ability to heal it. And by the way, lack of proper sleep drives sugar cravings and carb cravings, which makes it nearly impossible to stick to a healthy, anti-inflammatory food plan!

Learning to Say No — This is not scientific, but this is my observation in working with hundreds and hundreds of women: You can heal your autoimmune condition by holding your boundaries firm. No more giving away your time, no more saying yes to things that don’t serve you. Taking care of yourself means saying no. Or in other words, when you say no, you give yourself the space you need to heal. Want to read more on this subject? Check out 8 Reasons All Women Need Non-Negotiable Self-Care

Understanding Hidden Infections: Doing everything and still symptomatic? You may need additional testing. Functional medicine will help you get to the root of the problem.

AND FINALLY:  

The KEY that I promised you – CONSISTENCY:  

Yes, consistency! Taking imperfect action daily. Notice I said “imperfect.” We’re not trying to be perfect. In fact, it’s impossible to be perfect. It’s not all or nothing. When someone starts something new, they often give up. If they can’t do it “right,” they don’t do it at all. (Think New Year’s Eve resolutions. Done by February 1st!) You can be consistent. You can even learn to be consistent if it’s eluded you in the past. It’s all about figuring out your personal plan … a combination of what you need right now and the baby steps you need to get there. 

And, this is where it’s important to have a coach or a coaching program so that you’re not figuring it all out alone.

Are you ready to begin reversing your autoimmune condition? Join Dr. Blum and me for Immune System Strong!   Get On The First-To-Know List (even if you’re only a little bit interested), because we’ll be rewarding with an offer that won’t be available to anyone else.) I want the special reward!

Meet Melissa: Melissa Rapoport is the Manager of Health Coaching and Lifestyle Programming at Blum Center for Health in Rye Brook, NY. She combines her graduate work in Developmental Psychology with her education in nutrition, health and coaching to create highly individualized programs that result in lifetime change. A contributing author to three international bestselling books, Melissa’s greatest joy is her relationship with her two daughters.

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How Conventional Medicine Gets Autoimmune Disease Wrong

Here’s a common scenario in our practice:  A patient comes in with a prior diagnosis of autoimmune disease. Sometimes it is a new diagnosis, and the patient is worried about how to proceed. Sometimes it is a longstanding illness they have lived with for much of their life. In most cases, they are looking for help where the conventional approach to autoimmunity has failed them.

There are many different types of autoimmune disease. All have in common the curious fact that the person’s immune system has become misdirected. The immune system is meant to provide protection against infection and foreign invaders to the body – like bacteria, viruses and other pathogens. When one has autoimmune activity, it means that the person’s own body is under attack.  

Falling under the umbrella of autoimmune disease is a variety of ailments, which vary widely in prevalence, symptomatology and severity. Some autoimmune diseases are very common, like Hashimoto’s thyroid disease. Others are rare, like Scleroderma. Some attack a single part of the body, like Hashimoto’s, while others, like lupus, can be more systemic, attacking multiple organ systems. Other examples of autoimmune disease are rheumatoid arthritis, multiple sclerosis, Grave’s disease, Type I diabetes, inflammatory bowel disease, psoriasis, and alopecia.

The Typical Conventional Response to Autoimmune Disease

Patients routinely describe that their physician — be it primary care or specialist — has diagnosed a condition or worse, a disease. Sometimes the patient is already on prescribed medications as treatment, but other times they are not.

Invariably, what they have been told is that there is nothing to be done:

  • “We will wait and see.”  
  • “You will probably need to be on medication at some point.”
  • “Let’s continue to watch your blood testing yearly and wait and see when symptoms develop.”  

Few, if any of these doctors, offer advice on how to potentially keep the disease from progressing. Or, if already in the throes of symptomatic disease, offer suggestions how to lessen the symptoms with anything but anti-inflammatory medications, replacement hormones or immune-modulating drugs.

This is a very serious problem, and a failing of conventional medicine. It’s exactly why our practitioners chose to continue their training with the Institute for Functional Medicine.

A Functional vs Conventional Approach to Autoimmune Disease

Let’s take the case of early autoimmune thyroid disease:

With Hashimoto’s, for instance, the patient will often be told that they have autoantibodies – which means there are immune markers in the bloodstream directed not against invaders, like bacteria or viruses, but actively attacking the body’s own tissues of the thyroid or its receptors. This is the basis of autoimmune thyroiditis, or Hashimoto’s thyroid disease, which often leads to low functioning thyroid and the need to take thyroid hormone medication.  

The conventional doctor will let the patient know that these antibodies are there, and that most likely the thyroid will begin to malfunction, causing too little hormone to be released into the blood and causing the symptoms of hypothyroidism – low energy, weight gain, constipation, dry skin …  When that occurs, treatment with thyroid hormone replacement will begin.  

This leaves many people wondering – what can I do now?  Is there anything I can do to stop this from happening?  Am I going down a road I can’t switch out of?  

How can one reverse the damage – or halt the progression of the autoimmune disease ravaging the body?

The Functional Medicine Approach

We like to think of a Functional Medicine approach to treatment as two-fold:

  • Doing everything we can to improve the immune system’s ability to rebalance while…
  • Lessening the odds of the immune system continuing to rebel — and, quite possibly, beginning another attack on another system in the body — which could then lead to another autoimmune disease.

How do we do this? First, we work to support whatever system or systems in the body are under attack – replacing nutrients or hormones that are lacking due to the autoimmunity. We frequently use B-complex, D3 and multivitamin supplementation; and, of course, hormone replacement, as needed in hypothyroidism.

Then, we work to build resilience and decrease inflammation in the body by using good old detective work to find the root cause, or triggers, of the immune dysfunction, and treat that. We look at food, stress, gut health, toxin exposure and infections.

5 Steps to Decrease Inflammation & Rebalance Your Immune System

  • Practice improving your emotional and physical response to stress. Getting good sleep and exercising is imperative. Mindfulness meditation and other mind/body techniques are helpful for reducing stress hormones.
  • Experiment with your food – discover sensitivities, triggers, and intolerances. We usually recommend an allergy elimination diet – taking out gluten, dairy, soy, corn, and eggs, along with other common allergens depending on your specific medical condition- for a short time and reintroducing to see if symptoms are affected by food.
  • Support your microbiome and heal your leaky gut.  Eat healthy whole foods and lots of vegetables and fiber. Start taking a probiotic. Our go-to is Dr. Blum’s formula, created for our patients. Learn More
  • Decrease your exposure to toxins and improve your body’s ability to manage exposures. Watch out for common toxins in food (herbicides and pesticides), cleaning supplies, and even in personal care products.  We recommend looking at the Environmental Working Group and following their suggestions for cleaning up toxins in the home.
    If you are concerned about the toxin build-up in your body, you might want to consider our 21-Day Simply Detox. It’s the exact program we use with our patients at the Blum Center for Health. Learn More
  • Be assessed with functional testing for nutritional needs and to rule out any chronic or acute infectious disease processes.  We will often request stool testing for microbial balance, in depth blood testing for nutritional needs, and more extensive saliva and urine testing for hormone balance.

If you live near the New York City metro area, come see us! We would be happy to help. People travel from all over the world to work with us. Come join our family!

Keep your eyes peeled for our new LIVE course: Immune System Strong!  Slated to start late September (it will be here before you know it!) Immune System Strong will feature 4 LIVE classes with me that feature tangible next steps that you will be able to implement immediately, as well as community, accountability, group coaching and access to the answers you need on a daily basis.  Details will be available soon! Get On The First-To-Know List (even if you’re only a little bit interested), because we’ll be rewarding with an offer that won’t be available to anyone else.) I want the special reward!

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Viruses and Autoimmunity

If you are a human, living and breathing on this planet, then you have already discovered that viruses are everywhere.  

Sometimes you get sick from them and sometimes you don’t. Have you ever wondered why?  

Some people can clear these viruses out of the body easily after their cold or flu, while in other’s the virus can persist and run amok causing problems like autoimmune disease. How does that happen?  

This issue is important whether or not you have an autoimmune condition because persisting, active viruses can cause ongoing symptoms like fatigue, too.  

Let me explain.  

We are all exposed to viruses.  

A healthy immune system should be able to respond to the infection and take care of business, clearing out the virus after a self-limited short illness. I think of a robust and well functioning immune system as the product of good “soil” within your body.  

Another name for the inner soil that grows your immune system is your terrain, which is part of a larger ecosystem that determines the functioning of, well, every system in your body..  (note the gardening metaphors).

If you have good inner terrain, you will “grow” normal functioning immune cells that can clear out the viruses. If you don’t, then they can persist. We believe there is a genetic predisposition that allows viruses to persist and trigger autoimmunity.  

But that’s not all that’s going on. Twin studies have shown us that two people with the same genetics and the same triggering virus, can have two completely different responses, all because of their terrain.

By the way, you can repair your immune system terrain with me LIVE beginning Tuesday, October 16th → The Immune Recovery Challenge Begins!

How do Viruses Trigger Autoimmunity?

When viruses linger in the body (again, most often because of terrain issues), it is called “chronic persistence.” This leads to an ongoing antiviral immune response, which can trigger autoimmunity in a few ways.

First, the chronic antiviral immune response at some point moves from being focused on the virus to targeting your own tissue. This can be because the immune response becomes less specific and it spreads to other tissues.

Second, autoimmunity happens because the virus is inside your cells or damaging them and your immune system appropriately is attacking the cells to get at the virus.

And finally, as the virus continues to spread its “proteins” around your body, there is mistaken identity as these proteins can look like your own tissue. We call this molecular mimicry.  

But you can see, no matter the mechanism, to prevent and treat autoimmunity that has been triggered by viruses, you want to make sure your immune terrain is functioning well so that the viruses are cleared out and not allowed to become chronic persisters.

Here is how to improve your terrain to create a robust and healthy immune system to clear out viruses:

  1. Nutrition:  
    1. Anti-inflammatory diet: whole foods rich in antioxidants, low in sugar, animal and processed fats;  elimination of foods that trigger inflammation including gluten and gmo foods. Less animal, more vegetable.
  2. Balanced hormones:  
    1. Stress system and adrenals are balanced and resilient
    2. Sex hormones:  good estrogen metabolism; adequate androgens to balance estrogens
  3. Healthy Gut:  
    1. Intestinal ecosystem:  adequate beneficial bacteria, good barrier function
    2. Digestion:  stomach acid, bile acids, pancreatic enzymes
  4. Well functioning liver:
    1. Maintain a low toxic load
    2. Clean up environment and make sure biotransformation pathways through liver are working well
    3. Support Estrogen detox pathways

Remember, you can’t avoid viruses! They are everywhere. Instead we work on creating resilience in the immune system so that the viruses don’t become chronic. To do this, we focus on the terrain of the immune system, which leads to the 4-step Immune System Recovery Plan, the focus of my first book on autoimmunity.

How You Can Repair Your Immune System with Me

I am teaching the Immune Recovery Challenge online beginning next week. It is the step-by-step companion to my book, The Immune System Recovery Plan. During the course, you will follow the 4-Step Immune System Recovery Plan together with me LIVE, using video and live coaching. It is a wonderful opportunity, and I hope you’ll join me!  

>>Yes, I Want to Repair My Immune System LIVE With Dr. Blum<<

If you haven’t read The Immune System Recovery Plan, you can find it HERE. In print around the world, it has transformed the lives of tens of thousands of people including my patients in my private practice.

 

References:  

Vieira et al.  Diet, microbiotia, and autoimmune diseases.  Lupus 2014 23: 518

Getts, D, et al.  Virus, infection, antiviral immunity, and autoimmunity.  Immunol Rev. 2013 September; 224 (1): 197-209.

Vanderlugt, C, and Miller, S.  Epitope spreading in immune-mediated diseases: implications for immunotherapy. Nature Reviews Immunology 2, 85–95 (1 February 2002)

 

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Leaky Gut and Food Sensitivities

Did you know that your biggest exposure to the outside world every day is through your mouth?  That’s why 70% of your immune system lives in your gut, lying in wait to protect you from anything that seems foreign to the body (called antigens because they stimulate the immune system), which believe it or not includes food and the toxins and microbes that ride along with the food that you ingest while eating.

Your gut, which starts in your mouth, travels through your stomach, small intestine, colon or large intestine, and ends in your rectum, is supposed to be a closed tube – with the intestinal lining creating a barrier that separates the inside of your body and immune system from these outside exposures.  When you digest your food, the intestinal lining can then selectively choose what can enter your body by opening and closing special gates called tight junctions.

In functional medicine, an intestinal barrier with damaged tight junctions that isn’t keeping antigens out of the body is known as a leaky gut.  Studies have increasingly found that a leaky gut is associated with arthritis, autoimmune disease, allergies, and food sensitivities.

Causes of leaky gut vary, but the most important is dysbiosis, which is an imbalance in the bacteria in the gut, also called the gut microbiome.  Dysbiosis can be an overgrowth of harmful bacteria, yeast or parasites, or not enough good bacteria, and is commonly caused by a poor diet, a course of antibiotics, frequent use of antacids, and stress. These gut bacteria are important because not only do they interact with your immune system to keep it healthy, they also turn the food we eat into healthy compounds, especially something called short chain fatty acids which heal the tight junctions between your cells and protect the integrity of the gut barrier.  This is why food is so important, too, because the food you eat determines which bacteria will thrive and what kinds of compounds they will make when they digest your food.  

But why is leaky gut associated with inflammatory disease like arthritis? When the contents of your gut, which includes pieces of food and gut bacteria, “leak” into your body, your immune system is activated creating inflammatory chemicals that travel throughout your body and cause system-wide inflammation, especially in the joints. And this happens non-stop until your gut microbiome and lining are repaired.  

The good news is that you can rebuild your microbiome and repair your gut. Food has the most influence on the diversity of the microbiome, and that’s why you should always start with changing your diet by increasing fruits and veggies, especially those rich in polyphenols, bioflavonoids, and fiber because these tend to increase the good bacteria that make short-chain fatty acids and heal the gut. Also, you need to remove foods from your diet that feed the bad bacteria like sugar, processed flour products, alcohol, and too many animal products.  You also need to test yourself for food sensitivities and remove sensitive foods such as gluten, dairy, soy, corn, eggs and the nightshade vegetables. Our elimination diet explainer shows how to do this.

The next step is to treat your dysbiosis. At Blum Center for Health we start with cleansing herbs like berberine, grape seed extract, black walnut, and oregano that can clear out bad bacteria and yeast. In fact, we created our own custom herbal antibiotic mix called Gut Cleanse. You can do the program alone, or as a part of the Arthritis Challenge.  Once you have eliminated the bad bacteria and yeast, probiotics and the right food can help you rebuild the good stuff, repair the gut lining, reduce inflammation, and eliminate food sensitivities.  

For more, please review the video above.  Y

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How to Effectively Navigate an Elimination Diet

Perform an Elimination Diet

Elimination diets are the cheapest, most effective way of identifying the foods that trigger inflammation and disease in your body. For many, elimination diets hold the key to conquering chronic pain and I use one with arthritis patients as outlined in my book Healing Arthritis.

The great news, is that elimination diets are generally short and easy to follow. My elimination diet requires just two main steps.

Step 1:  Remove Gluten, Dairy, Corn, Soy, Eggs and Sugar From Your Diet For 3 Weeks

Gluten, dairy, corn, soy, and eggs represent the most common culprits for food sensitivities. Eliminating them makes it likely you’ll be cutting your problem foods from your diet. Sugar is also removed because it is a trigger for inflammation and removing it will help you learn to avoid processed foods, which usually include the common culprits, too.

A lot of times my patients ask me why we are removing all five foods at once, and whether it would be better or just as good to remove one at a time.  However, first you have to remove the foods and feel better, and then you can reintroduce each food one at a time to see if you feel worse.  If you only removed one food, you might not feel better because you are still eating another problem food.  It would be hard to complete the experiment because you might not notice you feel worse when you reintroduce the food, because you never felt better in the first place!

Continuing the diet for three weeks will give your immune system a chance to quiet down without the food triggers around.  More importantly,  it should reduce your symptoms and help you feel better.

Step 2:  Reintroduce Each Food One at a Time

Good job on making it three weeks without eating gluten, dairy, corn, soy, eggs and sugar! Now, you begin the second, and final, step, which is the reintroduction of each food, one at a time.

This is when you will gather all the information about whether the food is good for you or not and you’ll uncover some food sensitivities.  Use this symptom chart to help you keep track.

Symptom Chart - Blum

For each food that you reintroduce, think about the symptoms on your list and use none, mild, moderate, or severe to describe your reaction to it in the boxes provided. This will help you remember later when you look back.

After the three weeks on the elimination program, do the following. Introduce one food at a time:  It doesn’t matter which order you choose to reintroduce the foods.  I usually tell my patients to choose the food you miss most to go first. Eat that food at least twice each day, for two days, noticing how you feel.  On day three, don’t eat the food, but continue to observe how you feel. If you have no reaction to the food, you are ready to move on to the next food on day four.

If you do have a reaction – such as headache, rash, brain fog, fatigue, digestive reaction, or other symptoms – stop eating it, and write it down in the above table so you don’t forget later.  [Once you know a particular food isn’t good for you, remove it again.]  The food reaction should go away within a day or two, but for some people it can take longer.  Try the next food: Once that reaction goes away, it is time to try the next food.

Finding out if you are having a noticeable reaction to gluten is important. If you don’t have a reaction and don’t have an autoimmune disease, you can add it back into your diet.  However, keep in mind that gluten is known to damage the gut, and so we still recommend eating it in limited amounts.

Be patient, because it will take you another two weeks or so to reintroduce all the foods you have eliminated. At the end of those weeks, you should now know whether gluten, dairy, corn, soy, or eggs are creating an immune reaction in your body.

Once you’ve identified your triggers you can successfully avoid them. But the better news is that it may not be permanent. Some people, after an additional period of healing, can reintroduce the foods and be symptom-free. In my own experience, I have been eating a diet 95% free of these foods for more than ten years, my reactions when I do eat them are minor compared to what they once were. They are still there, but it’s much more pleasant than it used to be!

Looking to make your elimination diet successful? Sign up for the email list (on the bottom right of this page) to stay up to date on our next article “5 Things To Know Before Starting an Elimination Diet”!

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What’s the Difference between a Food Allergy and a Food Sensitivity? An Interview with Sezelle Gereau, MD

There’s a lot of buzz these days about food allergies and sensitivities. There’s a lot of confusion too. We spoke with our resident expert, Sezelle Gereau, MD, to learn the difference between the two and why it matters.

What is the difference between a food allergy and a food sensitivity?
When one is allergic to a food the body recognizes it as a pathogen, and goes through a set of immunologic responses to attack and contain it.  They can be life threatening, as we recognize with children and peanut allergy.  While sensitivities can be uncomfortable, they do not trigger the immune system in the same way.  So, one can be either allergic or sensitive to a food, although the two are often confused.  For example, one can have a true allergy to milk, or a lactose intolerance, which is more of a sensitivity and not a true allergy.

If a food sensitivity does not trigger the immune system in the same way as a food allergy then why are they so uncomfortable?
Sensitivities are different, both in their symptoms and their underlying mechanisms. Most commonly one will present with gastrointestinal symptoms such as gas, cramps, bloating, heartburn, headaches, or irritability. Some will complain of brain fog and fatigue. The most common food sensitivity is lactose.  Sulfites and alcohol are other frequent offenders.

What about gluten?
Common, but not as much as generally thought by the public, is gluten sensitivity – you can be allergic to wheat, or have a sensitivity to gluten. A gluten sensitivity is not a true allergy, but can trigger a set of responses that feel like an allergy.  Celiac disease is an autoimmune disease also related to sensitivity to gluten, but again, not an allergy. It is important to know if one has gluten sensitivity, as it can lead to issues in other parts of the body, such as your thyroid gland.

Do we outgrow allergies and sensitivities?
One can outgrow food allergies. Many children have food allergies early in life, and they commonly outgrow them by about age 8.  Food sensitivities are idiosyncratic, and there is no specific pattern.  The best way to train your body to outgrow both allergies and sensitivities is to eliminate the food completely.  Sometimes foods can be re-introduced on occasion without adverse effect, but if one has a severe reaction it is recommended that you completely eliminate these foods from your diet for good.

How do I know if I have an allergy or a sensitivity?
There are a number of ways to test for food allergies, including blood tests such as IgE or IgG.  You may have heard of the ALCAT or MRT testing.  Your doctor may choose to do any one of a number of these, and each has its pros and cons – but the best way to understand if one is allergic or sensitive is to eliminate the food strictly for 3-6 weeks and then reintroduce it in small amounts, one by one over a series of days and observe for reactivity.

When should I call a doctor?
Many times a functional medicine doctor, such as one of our doctors at Blum Digital, LLC, can help you sort out these issues.  They can help you start to grapple with your reactions and relationship to foods.  A comprehensive history with some additional testing can help one to understand if this is truly reactivity to foods, or if something else is out of balance in the body.

What’s new and exciting?
An exciting new treatment available for food allergy is allergy drops – which offers a way to eliminate the allergy entirely, not just control symptoms.  It is safe and effective for both adults and children. Come in for a visit if you’d like to learn more.